Infant Mortality Rate: too varied to celebrate
IT MAY bring some relief that the Infant Mortality Rate (IMR) in India has fallen from 50 to 32 per 1,000 live births over the past decade, but the wide variation in numbers across the country offsets the achievement. Data released recently by the office of the Registrar General of India in its Sample Registration System bulletin shows that the numbers vary dramatically among states and between rural and urban areas. Nagaland, for instance, reported the lowest IMR of 4, while Madhya Pradesh reported the maximum IMR of 48.
The bulletin has divided states and Union Territories into three categories—bigger, smaller and Union Territories. States and Union Territories with a population of more than 10 million as per Census 2011 are in the “bigger” category. While three “bigger” states—Delhi, Maharashtra and Tamil Nadu—have IMR within 20 (13, 19 and 15 respectively), in four states, IMR has crossed 40—Assam has 41, Chhattisgarh 41, Madhya Pradesh 48 and Odisha has 40.
The variation is wide even among smaller states—37 in Arunachal Pradesh and four in Nagaland. Similarly among Union
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Territories, IMR varies between 16 and nine in Andaman and Nicobar Islands and Daman and Diu.
It is no surprise that IMR is higher in rural areas than in urban areas. In rural India, one in every 28 infants dies within the first year of their life, while the figure is one in 43 for urban areas, the bulletin states. Delhi, Tripura and Puducherry are the only places that have higher IMR in urban areas than in rural areas.
In Madhya Pradesh, IMR ranges from as high as 52 in rural areas—the highest anywhere in the country—to 36 in urban areas. Similarly, Uttar Pradesh has 46
IMR in rural areas but 35 in urban areas. Among smaller states, rural and urban IMR fluctuates from 35 to 17 in Meghalaya. In Dadra and Nagar Haveli, IMR in rural areas is 19, but nine in urban areas.
IMR is widely accepted as a crude indicator of the overall health scenario of a country or region, the bulletin states. In the past decade, IMR has witnessed a decline of 35 per cent in rural areas and 32 per cent in urban areas. Yet, one in 31 infants dies within the first year of birth, irrespective of urban or rural. This speaks volumes of the country’s healthcare conditions.
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